Ask the Plastic Surgeon

Got a question for a Plastic Surgeon? This issue, your questions are answered by Consultant Plastic and Reconstructive Surgeon, Dr Lee Kim Siea.

March 12, 12:40 PM

PUMP UP THE VOLUME
I’m a thirty-year old professional who’s been contemplating a breast augmentation. While I’m quite happy with my breasts’ size, the upper half of my chest has become less voluminous and turned flat over time. Since I don’t want my breasts’ size to change but want some volume on top instead, what procedure would you recommend?
Jean, Seremban
Breast augmentation
From your description, it sounds like you only want added volume in the upper half of your breasts. In this situation, I would highly recommend fat grafting. Fat grafts can help achieve your needs, but yet will not change the size of your original breasts too much. What it basically does is enhance the chest in order to provide more volume, and fill up empty spaces in your bra. Besides feeling and looking very natural, patients needn’t worry about foreign body complications as fats are extracted from your own body and injected into breasts. Alternatively, small breast implants may be another option, as long as you are accepting of medical device implantations, which risk foreign body concerns. 
 
TUCK IT IN
My mum is a 60-year old woman with loose skin at the lower part of her tummy. Unlike other women, mum is extremely active and has a great body. While her stomach is quite flat, she does complain of redundant skin which hangs over her jeans. According to online research, mum may be a good candidate for a mini tummy tuck. Is this true? If it is, what does the procedure entail?
KC, Sungai Buloh
Tummy tuck
Yes, she does sound like a good candidate for a mini tummy tuck. Here’s how the procedures works: while skin above the belly button isn’t touched, surgeons will improve appearances by excising all redundant skin below the belly button. In addition, surgeons will also perform a little bit of rectus muscle plications as well. In my opinion, it’s a good procedure for individuals who want excess skin removals along the lower tummy. Although you seem like a good candidate for mini tummy tucks, it’s of course subject to review. 
 
FACE FIRST
I’m a fifty-five-year-old woman with ageing skin. While I’m quite ready to undergo rejuvenative procedures, I don’t think invasive surgery is for me. In your opinion, are there other options for lifted, rejuvenated skin which doesn’t require nips and tucks? If there is, what treatments would you suggest?
Wendy, PJ
 
Ageing skin
Despite the many minimally invasive and non-invasive facial lifting options, outcomes will depend on patients’ expectations and current skin quality. Furthermore, patients have to ask themselves how much of an improvement they expect. If patients have manageable expectations including nominal skin laxity, then a few options can be recommended:
1)   Non-invasive medical devices: There are certain technologies which have dermal lifting abilities. These include Thermage, Ulthera or other High-intensity Focused Ultrasound (HIFU) devices. Such treatments are non-invasive and hence will not affect in dermal penetration and downtime. Despite their non-invasive natures, results are of course less discernible than more invasive options. 
2)   Fillers and botulinum toxin A (BTA): With injectable treatments, facial volumisers are able to fill and lift the skin. BTA however, not only relaxes hyperactive muscles but elevates facial tissues as well.
3)   Threadlifts: Threadlifts are procedures which necessitate suture insertions under the skin to lift sagging structures. Although the most effective of the three options, it is the most invasive and therefore may result in transient downtime, swelling and bruising.
 
NOSING ABOUT
I’m a young female of Chinese descent. I’ve been contemplating a nose job for about two years now but have been wary of the side effects. Despite having a nice nose bridge, I’m not happy with how wide my nostrils are. While I do desire a ‘pinched’ nose, I don’t want the procedure to hinder my breathing. In your opinion, are there rhinoplasty procedures which can reduce my nostril’s size without obstructing my airway?
Ash, Sunway
Nose job
I assume you are desiring an alar base reduction. This procedure calls for a narrowing of the nostrils, providing a more pinched appearance. When surgeons perform this procedure, we have to careful as to not create overly small nostrils which obstruct patients’ airways. To answer your question, yes, we will be able to minimise alar sizes without hindering breathing and this can be done – and accordingly adjusted – during surgery.